Extragenital endometriosis--a clinicopathological review of a Glasgow hospital experience with case illustrations

Abstract

The clinicopathological characteristics of 34 cases of extragenital endometriosis (mean age 33.74) presenting to surgeons over a 9-year period at Glasgow Royal Infirmary were reviewed. A total of 379 cases of endometriosis were diagnosed by histology during the period, giving an 8.9% prevalence of extragenital manifestations. Eleven (32.3%) cases were in the intestinal tract, two (5.9%) in the urinary tract and 21 (61.8%) were in other sites, including pfannenstiel scar, inguinal canal, umbilicus and perineum; 52.9% presented to gynaecologists and mean time to diagnosis was 24.54 months (CI: 13.2 - 35.8). Pain was the most common presentation in 76.5% but this was cyclical, reported in only 41.2%. Palpable mass was found in 41.2%, especially in pfannenstial scar (26.5%), suggesting iatrogenic cause. Histology remains the cornerstone of diagnosis and several of the case histories describe delay and diagnostic confusion. Endometriosis is rarely fatal, but continues to challenge patients and clinicians in all specialities in presentation and diagnosis.